• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.5 no.2
• /
• pp.158-165
• /
• 2002

Purpose: We designed this retrospective study to establish the incidence of diagnosic delay in children diagnosed with acute appendicitis and to identify associated factors with delayed diagnosis and its impact on the clinical course. Methods: All cases of children under 15 years of age who underwent appendectomy from 1996 to 2001 at Gangneung Asan Hospital were reviewed. We reviewed signs and symptoms, type of health professional first contacted, the advice given by the health professional and a history of appendicitis in first degree relatives. Diagnostic period is the time elapsed between first complaints and definitive diagnosis. Delay was defined as diagnostic period exceeded the 48 hours. Postoperative course and complications were also reviewed. Results: Incidence of diagnostic delay differed by whether diarrhea and fecalith on X-ray were present. Also children whose parents were advised to observe them at home were more likely to have a diagnostic delay. In almost half of the cases in delayed group, initial diagnosis was not acute appendicitis but gastroenteritis. The perforation rate in non-delayed group was 22%, whereas 87% in delayed group. The delayed group showed a higher number of postoperative complication and a longer hospitalization period. Conclusions: Diarrhea with abdominal pain and fever in children should not be dismissed as gastroenteritis, respiratory infections or other common disorders. Our study suggests that physicians have a responsibility to prevent diagnostic delay and resultant perforation of acute appendicitis in children by having a high index of suspicion about acute appendicitis.

• Childhood Kidney Diseases
• /
• v.9 no.1
• /
• pp.64-68
• /
• 2005

Purpose : Renal abscess is very rare in children and its diagnosis is difficult because symptoms are often nonspecific. In previous studies, on]y 15% to 25% of patients were reported to be diagnosed at the time of admission. Early diagnosis and treatment are important be cause mortality rate correlates positively with the time of diagnosis. The purpose of this study is to clarify the clinical features of children with renal abscess and to investigate the possible indicators of this disease for early diagnosis and Proper treatment. Methods : Twelve children diagnosed with renal abscess from Jan. 1996 to Jul. 2004 were included. The age of patients ranged from S months to 15 years. We retrospectively analyzed the demographics of patients, their symptoms, predisposing factors, diagnostic methods and causative organisms and the treatment modalities. Results : Fever was the most common manifestation, Five children(42%) had vesicoureteral reflux. Renal ultrasonography and computerized tornography were the most frequently used imaging tools to detect renal abscess. Gram negative bacteria were isolated in 7 patients and Staphylococcus aureus grew in 2 patients. All patients received intravenous antibiotics and 4 patients underwent aspiration or drainage of renal abscess. The average admission duration was 30 days. Conclusion : Renal abscess should be included in the differential diagnosis of prolonged fever in children, especially when flank pain is combined. For early diagnosis and a better prognosis, patients should be promptly investigated with ultrasonography or computerized tomography.

• Journal of Veterinary Clinics
• /
• v.28 no.6
• /
• pp.610-612
• /
• 2011

A 9-years-old female Collie dog was presented with history of abdominal enlargement, anorexia and constipation. On radiographic and ultrasonographic examinations, intra-abdominal mass was identified. On cytologic findings of the mass, no cancer cell was observed. Exploratory laparotomy was performed to diagnose and remove the mass. A large, single, spheroid mass weighing 9.5 kg ($40{\times}25{\times}18$ cm) was located in the middle section of the right uterine horn. Based on the results of histopathological examination, the mass was diagnosed as a cystic endometrial hyperplasia (CEH). This is rare case of severe focal CEH without pyometra in a bitch.

• Journal of radiological science and technology
• /
• v.24 no.1
• /
• pp.33-41
• /
• 2001

This study is to get preliminary data for an effectiveness evaluation of abdominal examination and improvement of it. Abnormal cases of abdominal ultrasonography are classified by sex, frequency, diagnosis and age. 4,924 examinees were included at a university hospital of health promotion center from January to December in 1999. The results are as follows. 1. According to the distribution of sex, there are more male patients(55.0%) than females patients(48.0%). For men, 40's showed the highest percentage among examinees. For women, 50's were the highest. 2. The reason that they visited the health promotion center was that 'they wanted to check their health status'. This answers were reported the highest(59.3%). 3. Patients that had abnormal cases of abdominal ultrasonography were 48.3%. Liver, kidney, gallbladder showed the highest percentage of abnormal cases in order of organs. Additionally, abnormal cases were discovered in liver cases. 4. According to the frequency of abnormal cases among examinees, the slight fatty liver were the highest regardless of sex. Men had the slight fatty liver, kidney simple cyst, liver calcification and liver simple cyst in order of abnormal cases. Women showed the slight fatty liver kidney simple cyst, kidney calcification, liver simple cyst, and blood vessel tumor in order of abnormal cases. 5. For the abnormal cases of liver by sex and age, the 50's reported the highest number of abnormal cases in men(299 patients). In addition, 60's had the highest of disease rata 47.8%. For women, 50's reported the highest number of abnormal cases(361 patients). Over 70's patients had the highest of disease rata 52.6%. For kidney, men and women showed the highest number of abnormal cases -62 vs 44 respectively. Over 70's patients had the highest percentage of disease rata-23.2% vs 14.0% respectively. For gallbladder, the number of abnormal cases were the most in men's 60's (31 patients) and in women's in the same age group (32patients). Disease showed the highest percentage in men's 60's(7.6%) and in women's 70's (14.0%). 6. According to malignant tumor, 17patients were liver cancer, 2patients stomach ca and 1pt kidney cancer. 7. The relationship between the malignant tumor and the examination motive was that 'they wanted to check their health status(41.0%)' and 'regular checkup (24.0%)'.

• Journal of the Korean Society of Radiology
• /
• v.1 no.2
• /
• pp.5-11
• /
• 2007

Intussusception is one of the most common cause of bowel obstruction in infant under the two years old, especially in male. Clinical analysis was enrolled on 54 intussusception cases who were diagnosed by ultrasound and treated by non-operative reduction at the Presbyterian Medical Center from June 2005 to May 2007. The results were as follow. 1) There was the most common(40.7%)between thirteen and twenty four months on the distribution of age. Male(72.2%) and female(27.8%) were in the ratio of 2.6:1 on the distribution of gender 2) The frequent symptoms were abdominal pain with grizzle(100.0%), vomiting(66.7%) and diarrhea(33.3%). There was a significant difference among them(p<0.05). There was the most common(46.3%) between 10,000/$mm^3$ and 15,000/$mm^3$ in the result of WBC. 3) 42.6% of patient at a private hospital performed primary care. The treatment after initiating the symptom of intussusception was performed between 6 hrs and 12hrs (37.0%). 4) The most common type and portion of intussusception were ileo-colon(98.1%) and hepatic flexure (68.5%). 5) 88.0% at air reduction and 86.2% at barium reduction were successful. The reduction rate were similar to both techniques. There was no significant difference between them(p>0.05).

• Journal of Gastric Cancer
• /
• v.3 no.4
• /
• pp.182-185
• /
• 2003

Purpose: Preoperative staging of gastric cancer is crucial because the treatment modality and the prognosis depend upon the stage of gastric cancer. Current treatment modalities for early gastric cancer have focused on the quality of life. Endoscopic ultrasonography (EUS) and abdominal computed tomography (CT) are commonly used diagnostic tools to evaluate the invasiveness (T stage) of the primary tumor. The purpose of this paper is to evaluate the sensitivity and the specificity of preoperative EUS and CT in comparison with postoperative pathology. Materials and Methods: From October 2001 to October 2002, EUS and abdominal CT were performed simultaneously on 75 patients who underwent radical gastric surgery for the treatment of gastric cancer. Through analyzing the clinical T stage and the pathologic T stage, We evaluated the diagnostic sensitivities and specificities of endoscopic ultrasonography and abdominal computed tomography. Results: The male-to-female sex ratio was 1 : 0.6 (males: 47, females: 28). The mean age was 55.4 years in males (range: $28\~81$) and 54.4 years in females (range: $23\∼77$). The clinical T stage based on EUS included 22 T1mm, 7 T1sm, 22 T2, and 24 T3. The clinical T stage based on CT included 20 Tx, 23 T2, and 32 T3. The permanent pathologic report confirmed 23 T1mm, 10 T1sm, 17 T2, 24 T3, and 1 T4. The sensitivity and specificity of EUS were $84.2\%\;and\;94.7\%$, respectively. However, the sensitivity and specificity of abdominal CT were $53.3\%\;and\;77.0\%$, respectively. Conclusion: Our data suggest that EUS is a very useful diagnostic tool for evaluating the T stage of gastric cancer because EUS has higher specificity than abdominal CT. Therefore, EUS may have a significant role as a preoperative diagnostic modality in patients undergoing minimally invasive surgery.

• Journal of Gastric Cancer
• /
• v.7 no.2
• /
• pp.102-106
• /
• 2007

Gastric carcinoid tumor is a neoplasm that arises from enterochromaffine-like (ECL) cells in the gastric fundus. It is a rare disease that comprises less than 2% of all gastric neoplasms; however its incidence has been recently increasing. We experienced one case of gastric carcinoid tumor that was revealed to be multiple polypoid lesions. A 29-year-old female patient visited a hospital three years ago due to syncope. The blood hemoglobin was measured as 6.0 g/dl. Gastroscopy revealed multiple polypoid lesions with bleeding; therefore endoscopic clipping was performed. The polyps were diagnosed as carcinoid tumor via endoscopic biopsy. She was transferred to our hospital because of persistent iron deficiency anemia that was caused by bleeding at the gastric polyps. Gastroscopy revealed more than twenty various-sized polypoid lesions from the mid-body to the antrum. The blood hemoglobin level was 9.0g/dl. Total gastrectomy was performed under the diagnosis of gastric carcinoid tumor with bleeding. All of the gastric polyps were diagnosed as carcinoid tumors, and any metastasis to the regional lymph nodes was not found. Eighteen months after operation, the blood hemoglobin was increased to 12.8g/dl with no evidence of recurrence. Surgical resection should be considered for treating gastric carcinoid tumor with continuous bleeding.

• Journal of Veterinary Clinics
• /
• v.23 no.2
• /
• pp.175-179
• /
• 2006

A 7-year-old, 3.16 kg intact male Yorkshire terrier had the history of abdominal distension, diarrhea, and weight loss. On the basis of history takings, physical examination, laboratory tests, radiography, ultrasonography, exploratory laparotomy, and histopathological examination, the dog was diagnosed definitely as intestinal lymphangiectasia. In this case, signs and results are consistent with those of other reports, but some clinicopathological findings such as hypocalcemia and hypocholesterolemia are not. This means that the findings were not completely in accord with the typical ones of intestinal lymphangiectasia in this dog. Prednisolone was prescribed to treat. However, it was not effective sufficiently. Thus, azathioprine was added to the regimen used in the first trial, and it was quite efficient in inducing remission in intestinal lymphangiectasia. The clinical signs were improved to the combined therapy. This case report demonstrates that the combined therapy for intestinal lymphangiectasia can be used as an alternative to only glucocorticoid therapy.

• Journal of Veterinary Clinics
• /
• v.29 no.1
• /
• pp.18-22
• /
• 2012

This study was performed to evaluate the sensitivity of conventional film-screen radiography (CFSR) and direct digital radiography (DDR) for detection of various amounts of free peritoneal fluid. Ten adult male healthy beagles were used in this study. Radiographic examinations were performed in the right lateral and ventrodorsal positions. Fluid was injected in increments of 2.0 ml/kg of body weight up to 20.0 ml/kg of body weight. The images of CFSR and DDR were evaluated by two veterinary radiologists for evidence of abdominal fluid without knowledge of injected fluid volume. Data were evaluated by using the receiver operation curve (ROC) analysis and the area under the curve (AUC). There was no significant difference in detection of peritoneal fluid between DDR and CFSR in the ROC analysis. The accuracy of CFSR (0.805) was relatively higher than that of DDR (0.733), based on the ROC analysis and AUC. AUC of CFSR was higher in most injection doses. These results suggest that CFSR is more accurate than DDR for the detecting peritoneal fluid. Therefore, for situation in which digital radiographs are equivocal or small amount of fluid is suspected, other imaging modalities, such as ultrasonography would be helpful for determining the presence of fluids.

• Childhood Kidney Diseases
• /
• v.1 no.2
• /
• pp.151-154
• /
• 1997

Purpose : The prevalence of renal malformation in Turner syndrome has been quoted as being greater than 50% in older series. Recently in 1988, Lippe's review gave a prevalence of 33%, significantly lower than all previous reports. In 1996, Flynn reported that renal malformation occurs in approximately 24% of all girls with Turner syndrome, and that it is seldom seen in girls with mosaic karyotype who form the predominant subgroup. The aim of this study was to evaluate prevalence of renal malformation by karyotype in Turner syndrome in Korea. Method : We evaluated 81 patients with Turner sundrome diagnosed in Yonsei University from Jan. 1987 to Dec. 1996. The patient entered in this study were those for whom both karyotype and ultrasound examination of the kidney were available. Result : 1) The karyotype showed: 45,X ; 29 cases (38%), mosaicism : 32 cases (40%), structural aberration ; 17 cases (22%). 2) Of the 29 cases of pure 45,X karyotype, 5(17%) had abnormal renal findings, while these were found in only 1 of the 30 mosaic cases(3.3%), and in 1 of the 17 structural aberration cases(6%). The malformation included 3 cases of horseshoe kidney, 2 cases of axial malrotation, hypoplastic kidney and simple cyst each one. There was no statistical significance between 3 groups (p=0.09). Conclusion : We conclude that renal malformation occurs in 9.2% in this study, therefore Korean girls with Turner syndrome have lower rates of renal malformation.